Umbilical hernias are common in children, occurring in up to 10-20% of infants. For reasons that are unclear, they are much more common in black children. They are also more common in premature infants and infants with low birth weight. They can be associated with other conditions but that is rare. They are almost always harmless and the majority go away by themselves by five years of age.
What are the symptoms?
- The navel will protrude, especially when crying or straining.
- It can be pushed down with gentle pressure.
What causes an umbilical hernia?
The umbilical cord takes the baby’s blood back and forth from the placenta, where it receives oxygen and nutrients and gives away carbon dioxide and other waste products. There is an opening in the tissues of the abdominal wall to allow the blood vessels in the cord to pass through. These vessels pass from the placenta, through the cord and into the baby. The opening is present in all babies at birth and gradually closes as the baby grows, with most closed by 4-5 years of age and virtually all by 10-11 years of age.
What should I expect?
They are almost always cause no symptoms and no complications. In rare cases, they can interfere with feeding or part of the bowel can become obstructed, but this is only in very large hernias. It can become larger during the first year, as crying and straining pushes pressure and fluid into it and the child grows. But the ring/defect itself is usually getting smaller, and usually closes by itself. It starts to decrease in size after 6-12 months of age. When doctors are talking about the size, they mean size of the hole, not how tall or wide the hernia looks. Openings in the tissue greater than 1.5 cm (a little larger than ½ inch) are less likely to resolve on their own.
How is it treated?
No treatment is necessary. Do not put tape, coins, or a band over it. This will not help, and can cause skin irritation or other problems. If the opening in the tissues is not getting smaller by 4-5 years of age, then surgical closure can be considered.
What complications should I look for?
Rarely, the intestines can enter the hernia (if there is a large opening in the tissues) and the intestines can become trapped or twisted, which is an emergency. It causes pain, vomiting, and a red, tight or firm, and/or discolored hernia.
How can umbilical hernias be prevented?
There is no known way to prevent them. Putting a band, coin, or tape over them will not make them smaller or go away.
When should I seek further care?
Seek immediate care if:
- The hernia is firm, painful, red, or discolored.
Talk with your doctor if:
- The hernia is not getting smaller by 4-5 years old, or is causing symptoms or is bothering your child.
